Prosthetic legs, or prostheses, can help people with leg amputations get around more easily. They mimic the function and, sometimes, even the appearance of a real leg. Some people still need a cane, walker or crutches to walk with a prosthetic leg, while others can walk freely.
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If you have a lower limb amputation, or you will soon, a prosthetic leg is probably an option you&#;re thinking about. There are a few considerations you should take into account first.
While many people with limb loss do well with their prosthetic legs, not everyone is a good candidate for a leg prosthesis. A few questions you may want to discuss with your doctor before opting for a prosthetic leg include:
The type of amputation (above or below the knee) can also affect your decision. It&#;s generally easier to use a below-the-knee prosthetic leg than an above-the-knee prosthesis. If the knee joint is intact, the prosthetic leg takes much less effort to move and allows for more mobility.
The reason behind the amputation is also a factor, as it may impact the health of the residual limb. Your physical health and lifestyle are also important to consider. If you were not very active and lost your leg due to peripheral vascular disease or diabetes, for example, you will struggle more with a prosthesis than someone who was extremely active but lost a limb in a car accident.
When it comes to amputation, each person is unique. The decision to move forward with a prosthesis should be a collaborative one between you and your doctor.
If your doctor prescribes a prosthetic leg, you might not know where to begin. It helps to understand how different parts of a prosthesis work together:
There are numerous options for each of the above components, each with their own pros and cons. &#;To get the right type and fit, it&#;s important to work closely with your prosthetist &#; a relationship you might have for life.
A prosthetist is a health care professional who specializes in prosthetic limbs and can help you select the right components. You&#;ll have frequent appointments, especially in the beginning, so it&#;s important to feel comfortable with the prosthetist you choose.
Once you&#;ve selected your prosthetic leg components, you will need rehabilitation to strengthen your legs, arms and cardiovascular system, as you learn to walk with your new limb. You&#;ll work closely with rehabilitation physicians, physical therapists and occupational therapists to develop a rehabilitation plan based on your mobility goals. A big part of this plan is to keep your healthy leg in good shape: while prosthetic technology is always advancing, nothing can replicate a healthy leg.
Learning to get around with a prosthetic leg can be a challenge. Even after initial rehabilitation is over, you might experience some issues that your prosthetist and rehabilitation team can help you manage. Common obstacles include:
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Phantom limb pain, or pain that seems to come from the amputated limb, is a very real problem that you may face after an amputation. About 80% of people with amputations experience phantom limb pain that has no clear cause, although pain in the limb before amputation may be a risk factor.
Mirror therapy, where you perform exercises with a mirror, may help with certain types of phantom limb pain. Looking at yourself in the mirror simulates the presence of the amputated leg, which can trick the brain into thinking it&#;s still there and stop the pain.
In other cases, phantom limb pain might stem from another condition affecting the residual limb, such as sciatica or neuroma. Addressing these root causes can help eliminate the phantom pain.
At some point, you may notice that you aren&#;t as functional as you&#;d like to be with your current leg prosthesis. Maybe your residual limb has stabilized and you&#;re ready to transition from a temporary prosthesis that lasts a few months to one that can last three to five years. Or maybe you&#;ve &#;outwalked&#; your prosthesis by moving more or differently than the prosthesis is designed for. New pain, discomfort and lack of stability are some of the signs that it may be time to check in with your prosthetist to reevaluate your needs.
Your prosthetist might recommend adjusting your current equipment or replacing one of the components. Or you might get a prescription for a new prosthetic leg, which happens on average every three to five years. If you receive new components, it&#;s important to take the time to understand how they work. Physical therapy can help adjust to the new components or your new prosthetic leg.
There are always new developments in prosthetic limb technology, such as microprocessor-driven and activity-specific components.
It&#;s important to remember that you&#;re not alone in navigating the many different prosthetic leg options. Your care team will help you weigh the pros and cons of each and decide on the ideal prosthetic leg that matches your lifestyle.
Johns Hopkins Comprehensive Amputee Rehabilitation Program
Having the support of a dedicated team of experts is essential when recovering from the amputation of a limb. At Johns Hopkins, our team of physiatrists, orthotists, prosthetists, physical and occupational therapists, rehabilitation psychologists and other specialists works together to create your custom rehabilitation plan.
Learn more about our amputee rehabilitation programOsseointegration
An osseointegrated prosthesis offers many advantages to individuals with an arm or leg amputation compared with a socket prosthesis (which fits over the stump of the amputated leg or arm). The attachment of the osseointegrated prosthesis is much more stable and provides a full range of joint movement, making walking much easier. An osseointegrated prosthesis does not cause pain or skin breakdown when used. Because the prosthesis is directly attached to the bone, the wearer feels as though their prosthesis is part of their own body by a process known as &#;natural osseoperception&#; (i.e. it feels as though it is their own leg or arm). Since , the Radboud University Medical Centre (Radboudumc) in Nijmegen, the Netherlands, has been offering this highly innovative technique which significantly improves the quality of life of individuals with an amputation.In , the Radboudumc carried out a study of the first 22 patients to be given an osseointegrated prosthesis at their centre. Aspects of walking and quality of life with the osseointegrated prosthesis were compared with a socket prosthesis. It was found that prosthesis use increased from 56 to 101 hours per week, walking speed increased by 32% and walking required 18% less energy with the osseointegrated prosthesis. Prosthesis-related quality of life improved from 39 to 62 on a scale of 0 to 100.Osseointegration is a safe treatment, and inflammation of the bone is rare. A disadvantage is that the area where the implant enters the skin (called the &#;stoma&#;) has to be cleaned twice daily with soap and water. This is comparable with brushing the teeth. In some cases, the skin around the stoma may become irritated. In the first year after implantation, intense muscle pain may be felt. This muscle pain disappears as soon as the stump muscles become fitter and stronger.
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